冥想和瑜伽改善创伤后应激失调症！

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摘要：退伍兵事务部（VA）探索创伤后应激失调症（PTSD）的替代疗法。

图解：35岁的Michael Hanes 是参与伊拉克战争的海军陆战队老兵，他因背部疼痛在拉霍拉（La Jolla）VA医疗中心尝试瑜伽疗法。 John Gastaldo 摄于2010年1月8日。

Mike Hanes, a 35-year-old former combat Marine, sometimes closes his eyes and murmurs to himself when life gets tense.

35岁的前海军陆战格斗兵，Mike Hanes，在感觉不妙之际，便时不时闭上两眼，口中喃喃自语。

He’s repeating one word over and over, and it works as a “pause button” for his mind when he’s stressed out. It’s a form of meditation, one learned at the Department of Veterans Affairs hospital in La Jolla.

在他要发作的时候，他一遍又一遍的念叨着一个词，这就像是按了“暂停键”。这是拉霍拉的老兵事务部的医疗机构教授他的一种冥想方式。

Nationally, the VA is embracing alternative therapies to help veterans deal with combat stress and the physical pain that’s sometimes a memento of military service.

老兵事务局在全国范围推广利用替代疗法，帮助老兵们应对服役后遗症：战斗疲劳和身体疼痛。

Veterans can be referred to yoga classes, acupuncture, Tai-Chi and meditation and, in other parts of the nation, music therapy, energy healing and even sweat lodge sessions. At least 89 percent of VA medical centers offered alternative forms of therapy in 2011, with meditation as the most common form.

老兵们可以选择瑜伽班，针刺，太极和冥想疗法，在国内的其他地方，还有音乐疗法，精力修复，甚至桑拿聚会等形式。在２０１１年，提供替代疗法的老兵事务部医疗中心至少占到８９％，冥想则是最常见的形式。（配图：精力修复）

Some patients report that these therapies have allowed them to rely less on pain medication and sleeping pills. However, a May VA research conference concluded that evidence of the benefit of these therapies on post-traumatic stress disorder — possibly the signature wound of the Iraq and Afghanistan wars — is still thin.

一些患者反映说这些疗法已使他们减少了对镇痛剂和安眠药的依赖。五月份的老兵事务部研究会议最终结论却是：这些疗法，对创伤后应激障碍症起效的证据，仍然有限。该病症可能是伊拉克战争留下的特征性创伤。

Now VA researchers in San Diego, which has the largest population of post-9/11 military veterans in the nation, have received funding to conduct additional studies.

圣地亚哥的ＶＡ部门研究人员，目前收到了进一步研究所需的资金。该部门名下的后９１１时期退伍军人数在全国范围内为最多。

“We’ve done a lot of work in many areas of PTSD research that has produced effective treatments, but we are not done,” said VA Deputy Secretary W. Scott Gould, at the May conference in Washington, D.C.

老兵事务部副秘书 W. Scott Gould，五月份，在华盛顿特区举行的会议上说：“创伤后应激障碍的多个研究领域，我们已经做了很多工作，已经产生了很好的治疗效果，但是研究还未彻底完成”。

Silas Cochran placed his combat boots neatly next to his yoga mat. The Navy veteran says that in addition to helping his back, weekly yoga helps him slow down his thoughts. January 8, 2012 | Photo by John Gastaldo

插图说明：Silas Cochran把他的战靴摆在瑜伽垫的旁边。这名海军老兵表示，每周的瑜伽除了治疗他的背部毛病，还帮助他平缓思绪。

“That is why we need to keep our curious minds open and receptive to new ideas. In addition to the outstanding medical care we already provide, we are learning to extend that care to include many complementary and alternative medicine treatments.”

“这就说明我们需要好奇心，需要接受新观念。除了提供现有的优异治疗手段，我们正在学着扩大治疗方案，包括多种补充方法 ，替代性医学”。

Dr. Stephen Ezeji-Okoye, a Palo Alto physician who chairs the VA’s alternative medicine committee, said the effort began after a 2002 White House Commission report that encouraged the VA to look at the topic. To naysayers, he responds that the VA is venturing slowly and carefully toward these kinds of practices.

Palo Alto的内科医师 Stephen Ezeji-Okoye，VA替代性医学会议主席表示，2002年白宫委员会出笼的报告鼓励VA在该课题上的设想，一切都肇始于此。至于反对者，他回应称：VA在这方面的实践步调是缓慢而谨慎的。

“We’re looking at it not as, is it alternative medicine or Western medicine. We’re looking at it as, is it effective medicine,” he said.

他说：“我们不管它是不是替代医学或西医。我们看重的是起作用的医学”。

Hanes, who was in elite Marine force reconnaissance during the Iraq War and came to the VA to deal with combat stress, is a believer in meditation. He also is taking the La Jolla VA’s yoga series for back pain.

Hanes在伊拉克战争期间是一名海军陆战队的侦察精英。他也来到VA解除战斗疲劳，他相信冥想疗法。他同时还参与了瑜伽训练，以治疗背部疼痛。

“I noticed before, it was easier to fly off the handle,” said Hanes, who chose the word “shalom” as his meditation mantram, or mantra, as it’s more commonly known.

Hanes说：“我意识到我以前相当暴躁易怒”，他选了“ shalom（平安）”这个词，用于作为冥想的真言，或者俗称咒语。

“But now, you take that 10 seconds of saying your mantram, and it puts you back in focus, instead of doing something that you can really regret,” he said.

“花十秒钟念动真言，就会让你入定，避免做下令自己后悔的事”。

“I was very surprised to see the VA is offering this, and I think they should do a lot more of this type of stuff.”

"我非常惊讶的看到VA在提供这些疗法，而且我认为他们应该在这方面加大力度。"

With some young male veterans, meditation, Tai-Chi and other “new-age” therapies are a harder sell.

对于某些年轻男性退伍老兵来说，冥想，太极一类的“新世纪”疗法，还是较难接受。

Alternative therapy treatments being offered by the VA hospital include meditation. January 6, 2012 | Photo by John Gastaldo

插图说明：VA医院提供的替代治疗包括冥想

Joe Qualls, an Army infantryman in Iraq, said he has witnessed some of his tough-guy friends balk a bit when asked to do deep breathing exercises for relaxation. He would like to see the VA focus on offering recreational sports programs year-round, such as basketball leagues.

在伊拉克服役的陆军步兵Joe Qualls表示，他可以证明他的某些硬汉型的朋友，被要求做深呼吸放松练习的时候确有障碍。他更希望VA提供长期的娱乐性体育活动，例如篮球俱乐部联赛。

Currently, there’s a VA summer sports clinic in San Diego, and the VA sponsors athletic teams that compete in national special events. Also, nonprofit groups offer onetime getaways that veterans can be referred to. There’s nothing more regular.

目前在圣地亚哥有一家VA夏季运动诊疗所，VA也在赞助运动队参加全国赛事。非盈利组织也在给老兵有关的活动提供一次性的赞助。所缺乏的是长效机制。

“The physical piece is the key, at least for this generation,” said Qualls, 31.

31岁的Qualls说：“至少对于这一代人来说，身体部分的锻炼是关键”。

“It’s really just about getting out. Exercise allows us to focus on one thing, nothing else. We burn off the extra adrenaline and anxiety.”

他说：“就是力求解脱出来，体育锻炼就是能吸引注意力。把多余的肾上腺素，焦虑感，都消耗掉”。

That’s one step toward being in the right state of mind for traditional sit-down therapy for PTSD, he said. And, “there’s less the medication has to work on.”

在按原有套路坐下来接受治疗之前，这样作，会朝着大脑的良好状态靠近一步。而冥想疗法在这方面效果较为欠缺”。

Jill Bormann, a VA nurse researcher in La Jolla, has pioneered the institution’s work on mantram meditation.

Jill Bormann，拉霍拉VA护理研究人员，真言式冥想方面的研究先导者。

“Compared to case management alone, we have seen significantly greater reductions in PTSD-related depression and hyper-vigilance, and improvements in quality of life,” she said, referring to the results of two pilot studies and one large randomized trial.

依据两项对飞行员的研究以及大规模的随机试验结果，她表示说：“以单独个案的处理来比较，我们已经在PTSD有关的消沉情绪和过度警惕症方面，取得显著的消除效果，从而改善了患者的生活质量”。

Bormann has received approval to do two new projects on mantram meditation and post-traumatic stress.

Bormann已经接到上级批准，开展两项在真言冥想和创伤后应激失调症方面的新项目。

In the hope of attracting young veterans — a previously elusive group for any VA research — she plans to hold the sessions in the evening and on weekends. Another tactic she uses to reach out to younger people: Rebranding. She calls meditation a “pause button” for the mind, which appeals to the Xbox generation.

她的研究组之于其他VA的研究来说，早前并不受关注，她抱着吸引年轻退伍兵的希望，她只得筹划利用夜间和周末的会面时段来开展她的研究。重新包装，这是她用来吸引年轻人群所采取的另一种措施。为吸引Xbox游戏机一代，她把冥想称为心绪的“暂停键”。

The VA isn’t the only group doing work on meditation. Earlier this year, Hollywood director David Lynch’s nonprofit foundation launched Operation Warrior Wellness with $1 million in funding to teach transcendental meditation to veterans.

VA也不是致力于冥想疗法的唯一机构。好莱坞导演David Lynch的非盈利基金，今年早些时候发起了“战士健康行动”，出资一百万美元，资助向退伍老兵教授超脱冥想（注：即真言冥想）。

Yoga is another popular alternative therapy at the VA and elsewhere. A group called Yoga For Vets NYC began offering free weekly yoga sessions in the Big Apple this year.

无论在VA还是其他地方，瑜伽则是另外一种流行的替代疗法。今年大苹果市（注：纽约市别称）一家名为纽约老兵瑜伽修习组织，每周提供一次瑜伽的免费面授。

The La Jolla VA began offering yoga for lower-back pain in 2003.

拉摩拉的VA在2003年就开始提供针对腰部疼痛的瑜伽治疗。

According to questionnaires filled out by students between 2005 and 2007, people who attended the once-a-week class — and stretched at home — showed significant improvement in pain, depression, energy level and general mental outlook.

依据在2005到2007年间由学员填写的调查问卷显示，参与每周一次课程的人们——以及在家自修的人——其疼症，抑郁，精力，基本的精神风貌，都有明显改观。

VA psychologist Erik Groessl and others published a paper about the results, but they were stunted by the informality of the study. Groessl is hopeful that he will be successful this year in securing funding for a more scientific trial, after years of applying.

VA心理学家Erik Groessl 等人公布了有关该结果的论文，但是由于是非正规的研究，妨碍了他们获得社会的认可。 在经过多年的应用之后，Groessl认为他有希望在今年成功筹得资金进行更多科学试验。

Navy veteran Silas Cochran, 50, was one of nine men in a recent yoga class, held in a VA classroom with the desks pushed back. Cochran’s military-style combat boots were neatly lined up next to his yoga mat.

五十岁的海军退伍兵Silas Cochran，是最近一期九人瑜伽班的学员，他置身在一间VA的教室里，教室里的桌子都被推到了一边。 Cochran的军靴就整齐地摆在他瑜伽垫的近旁。

He rode a bus from Escondido to attend the session, so he really wanted to be there — despite being the leading jokester when the teacher gave commands such as “curl back like you are a beautiful flower.”

他从 Escondido开车来，这证明他愿意来参加治疗——尽管在老师发出“想象自己如同一朵美丽的花一样向后弯曲伸展”这类指令的时候，他是最逗人发笑的。

Stephanie Taborda is an recent veteran who gets acupuncture regularly at the VA Clinic in Oceanside. Dr. Kristin Bell treats several veterans in a group therapy class, usually accessing areas of chronic pain through the ears. January 6, 2012 | Photo by Peggy Peattie

插图说明：Stephanie Taborda是一名近期在位于Oceanside的VA诊疗所接受针刺治疗的老兵。 Kristin Bell医生在一个团体治疗班上接诊过几位老兵，一般都是通过耳朵来治疗慢性疼痛。

Seriously, though, as someone with bipolar disorder, he doesn’t want to take medication for his back pain.

只得注意的是，他患有躁郁症，但他不想采取冥想的方法来治疗他的背部疼痛。

“I notice a difference here when I leave the class,” Cochran said. “It helps me relax and get in touch with my body, and maybe even get in touch with my mind. Because when you relax, you can slow your thoughts down.”

“在离开教室的时候，我注意到了有所不同”，Cochran说。“有助我放松，了解我的身体，也许还能触碰到自己的内心。由于放松了自己，还能够令你的心境平缓下去”。

On any given week at the Oceanside VA clinic, veterans get needles poked in their ears for pain relief.

插图说明：每周在 Oceanside的ＶＡ诊疗所里，医疗人员在老兵们的耳朵上扎针，来缓解疼痛。退伍兵 Stephanie Taborda在ＶＡ诊疗所接受针刺。

Veteran Stephanie Taborda gets acupuncture at the VA Clinic in Oceanside. January 6, 2012 | Photo by Peggy Peattie

Dr. Kristin Bell, a VA primary care physician, has been offering acupuncture for chronic pain since 2003. She is able to do group sessions by placing needles only in ears.

ＶＡ普内科治疗主任医生，Kristin Bell自２００３年起就提供针刺疗法来医治慢性疼痛。她能够只在耳朵上施行针刺，对多人同时进行治疗。

Veterans are referred to her for chronic pain, most often in their backs and necks. But Bell said she gets patients who also have post-traumatic stress, and they report some relief, too.

来找她的老兵大多是背部和颈部的慢性疼痛。Bell 说她也收治了几名患有创伤后应激失调症的病人，这些病人也回应称症状得到了缓解。

“I have quite a number of patients who have PTSD, both new and old veterans, who say it really helps them be calm and improves nightmares,” Bell said. “Frequently people report improved well-being, mood and sleep even before they get pain relief.”

“我有相当数量的病患得了ＰＴＳＤ，年轻，年老的退伍兵都有，他们说该疗法有助于心绪的平复，消除噩梦”，她说。“即使疼痛还未缓解，他们通常会答复说：健康，情绪，睡眠都有改善”。

She asks patients about how acupuncture affects the need for medication.

她一直在向患者询问针刺是否影响了冥想治疗的需要。

“I have a lot of patients who have been able to lower their meds, or even go off chronic narcotics altogether,” Bell said.

Bell说：“很多患者都能够减少服药量，甚至完全摆脱镇静药物依赖。”

As attractive as that might sound, Bell said she has room for more patients.

Bell表示她还有余力接诊更多的病患，这和她对疗效的说法一样吸引人。

And Bormann, the meditation researcher, is looking for veterans for her PTSD studies. Anyone interested in participating, call the La Jolla VA at (858) 642-1616.

Bormann，冥想研究者，正在寻找退伍兵参与她的ＰＴＳＤ研究。有兴趣参与者，请拨打 (858) 642-1616。​​​